Ethan Andrew Crocker, DPT is a
Physical Medicine & Rehabilitation physician based in Austin, Minnesota. Ethan Andrew Crocker is licensed to practice in Minnesota (license number 12793) and his current practice location is 1000 1st Dr Nw, Austin, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(507) 433-8758.
NPI number for Ethan Andrew Crocker is 1003531336 and his current mailing address is 1000 1st Dr Nw, Austin, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1003531336.
Physician's Profile
| Full Name | Ethan Andrew Crocker |
|---|
| Gender | Male |
|---|
| Speciality | Physical Medicine & Rehabilitation |
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| Location | 1000 1st Dr Nw, Austin, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1003531336
- Provider Enumeration Date: 10/10/2022
- Last Update Date: 10/10/2022
Medical Identifiers
Medical identifiers for Ethan Andrew Crocker such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003531336 | NPI | - | NPPES |
| 12793 | Other | MN | MINNESOTA LICENSE DPT NUMBER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | 12793 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Andrew Crocker is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ethan Andrew Crocker, DPT
1000 1st Dr Nw,
Austin, MN 55912-2941
Ph: (507) 433-8758 | Ethan Andrew Crocker, DPT
1000 1st Dr Nw,
Austin, MN 55912-2941
Ph: (507) 433-8758 |
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